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Director, Business Operations

Posted: 11/18/2022

Position Title: Director, Business Operations
Open Positions: 1
Posted Date: November 17, 2022
Location: Independence, MO (Landmark Building)
Department: Claims Operations
Supervisor: Daniel Willis
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Summary The Director, Business Operations is responsible for leading and managing the day-to-day operations of the Appeals, Business Operations Support and Enrollment department functions to produce exemplary results. The Director, Business Operations provides appropriate technical and managerial support ensuring key performance indicators mandated by the Office of Personnel Management (OPM) and internal requirements and goals are met. This role interacts and coordinates with various departments to ensure appropriate data driven decisions are being conducted. The incumbent provides project leadership for ongoing process improvements, system enhancements and software implementations.
Duties • Responsible for providing operational and administrative oversight to the Appeals, Enrollment, and Business Operations Support departments. Responsible for ensuring business practices and processes are in line with industry standard practices. The Director, Business Operations, is knowledgeable of Federal, State and ACA requirements related to claims processing, appeals processing, and enrollment of membership and ensures that processes are in place to comply with these requirements. • Responsible for ensuring a competent and motivated staff through selecting, training, and directing department staff. Determine actions on promotions, termination, or reassignments of subordinates. Conduct meetings with subordinates to communicate organizational and departmental changes as necessary. Review ongoing performance of department staff and participate in development programs that provide for continuity of managerial and specialized skills and ensure appropriate succession planning for the Business Operations function. • Responsible for oversight of major company projects and initiatives that involve core processing systems, vendor relationships within the Operations division and ongoing leadership in implementing cost saving efficiencies with new technology. • Responsible for leading, managing and motivating staff to obtain performance levels at or above production standards relating to membership, appeals, and mailroom in-process inventory, turn-around time, and processing accuracy. Ensure that standards are in compliance with OPM requirements as well as internal protocols and goals. • Responsible for collaborating with appropriate department’s management team, maintain adequate security over documents and other confidential data as prescribed by company policies and required by State and Federal law, including HIPAA privacy and security provisions. • Responsible for facilitating a culture capable of supporting significant change initiatives based on the corporate focus of operational excellence and creating an exceptional member experience. • Responsible for the execution of best practices in appeals processing, claims technology, quality assurance, enrollment and member satisfaction initiatives. • Responsible for establishing and managing to a set of consistent key performance metrics in order to measure the function’s success and opportunities for process or procedural improvement. This would include the formal
Government Employees Health Association, Inc.
monthly reporting and presentation of key performance metrics and resource requirements progress against plan. • Responsible for facilitating a culture that embraces and utilizes process improvement techniques such as DMAIC, Six Sigma and LEAN Sigma. Responsible for leading a team of individuals who support process improvements throughout the company.
Education Requirements • Requires a B.A. /B.S. in Business or related field of study or equivalent work experience. Industry certifications preferred. Additional years of experience will consider in lieu of education.
Experience Requirements • Requires ten years of progressive experience in business operations or equivalent with at least five years of people leadership experience. • 5 plus years of project management experience preferred
GEHA is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. We celebrate diversity and are committed to creating an inclusive environment for all employees.
An Executive Order was released stating that federal contractors must require COVID-19 vaccinations for all US employees. As a company that works on federal contracts, we have a legal requirement to comply with the executive order, if it is enforced.

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